Vision Claim Processor

Review and file vision care claims by verifying patient information, service dates, and procedure codes against company policies. Assess submissions to determine coverage based on individual insurance plans and resolve standard or complex claims through to payment or contractual adjustment. Maintain accurate records of processed claims, document discrepancies, and ensure compliance with federal and state privacy regulations. Provide exceptional customer service to healthcare providers and policyholders by responding to inquiries, clarifying benefits, and guiding users through the claims process. Collaborate with departments like customer service and policy management to ensure seamless experiences and participate in quality assurance checks and audits.